A Case of Severe Lower Extremity Weakness with Thyrotoxicosis – A Reminder of Hypokalemic Periodic Paralysis

Craus S1,2*, Balzan D1,2, Vella J1,2, Debono R1,2 and Coppini D2,3

1Department of Medicine, University of Malta, Mater Dei Hospital, Malta
2Department of Medicine, Mater Dei Hospital, Msida, Malta
3Department of Diabetology, University Hospitals Dorset NHS Trust, UK

^*Correspondance to: Sarah Craus 

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Abstract:

Thyrotoxic Periodic Paralysis (TPP) is a known but rare complication of hyperthyroidism, characterized by acute onset of hypokalemia and muscle paralysis. The exact pathophysiology is still unclear, but studies suggest that thyroid hormones lead to sensitization of the Na/K-ATPase pump, leading to hypokalemia. Treatment includes potassium supplementation, as well as treating the underlying hyperthyroid state using anti-thyroid drugs, in conjunction with beta-blockers if necessary. TPP can be associated with life-threatening arrhythmias, and hence, awareness among physicians is necessary for early recognition and treatment. Here we report a case of TPP and discuss clinical features, pathophysiological hypothesis and recommended treatment options.

Keywords:

Thyrotoxicosis; Periodic paralysis; Hypokalemia; Graves’ Disease

Cite the Article:

Craus S, Balzan D, Vella J, Debono R, Coppini D. A Case of Severe Lower Extremity Weakness with Thyrotoxicosis – A Reminder of Hypokalemic Periodic Paralysis. Ann Clin Case Rep. 2024; 9: 2680.